The 4 C’s of Addiction: Control, Compulsions, Cravings and Consequences

Content reviewed by Karen Rubenstein, LMFT, Chief Clinical Officer at Cliffside Malibu

Contrary to many outdated stereotypes rooted in ignorance and prejudice, addiction does not result from moral weakness or lack of willpower. Addiction is a chronic and compulsive brain condition that interferes with how an individual thinks, feels and behaves. Although the initial decision to use substances is often voluntary, any drug use interrupts or complicates communication within the brain in intense ways. Repeated drug use can alter brain structure and functioning in such a way that the brain becomes motivated almost solely by substance-seeking and substance-using behaviors.

Addiction can be better understood by breaking it down into four C’s:

  1. Control
  2. Compulsions
  3. Cravings
  4. Consequences

#1. Addiction compromises self-control.

One of the most notable characteristics of addiction is that it interferes with the brain circuits that regulate self-control. This is why many people who struggle with substance use disorder (SUD) report a lack of control or a loss of control over substance use.

One’s initial decision to use alcohol or other drugs is often voluntary. However, it is crucial to understand that the brain is highly influenced by dopamine, which reinforces pleasurable and rewarding behaviors. A sober brain is usually motivated to seek dopamine through non-drug-related activities such as eating, socializing and having sex. However, once an individual’s brain is exposed to the dopamine surges often produced from certain kinds of drug use, the brain is no longer as motivated by natural rewards.

It is also essential to understand that dopamine surges tell the brain that something is happening that needs to be remembered. When dopamine surges occur from drug use, the brain changes in such a way that makes it easier for the individual to repeat the drug use. Therefore, although addiction can be recognized as a “lack of control,” a better way of understanding it is that addiction compromises self-control via repeated substance use.

#2. Addiction fosters compulsive behavior.

Another characteristic of addiction is compulsive behavior, which is an overwhelming impulse to behave a certain way. Sometimes, addictions and compulsions are understood as separate experiences. Some understand addiction as a persistent need to use a substance and that compulsion is an irresistible impulse to act. However, compulsive behavior typically begins first and can become an addiction once the behavior is no longer controllable and interferes with an individual’s ability to function.

#3. Addiction causes cravings.

Once the brain and body are exposed to the effects of substance use, they will seek out substances to achieve the perceived desired results. When substances are used repeatedly, the body begins to normalize substance use. Over time, the brain and body will begin to rely on substance use as means of feeling “normal.”

Cravings, then, are experienced as intense desires to use substances. They can occur when an individual is already under the influence of substances. However, they become more prevalent when an individual experiences withdrawal symptoms while sober or coming off a high. Cravings often trigger substance use, especially for individuals with SUD.

Many people tend to relapse because their desire to experience the pleasure achieved from substance use is so strong. Similarly, many people relapse because they cannot tolerate the uncomfortable symptoms that occur from withdrawal. To achieve initial sobriety, medically-supervised detox is essential as it keeps patients comfortable and supported as their bodies clear out any remnants of substance use.

#4. Addiction produces consequences.

Last but certainly not least, addiction is known to produce significant consequences in all aspects of an individual’s life. This is because, when addiction develops, substance-using and substance-seeking behaviors are prioritized above all else.

Social consequences of addiction

Socially, addiction often leads to legal problems, jail time, job loss and dropping out of school. Motivation to complete expected or everyday responsibilities is reduced significantly when substance use begins to impact one’s life. Other social consequences include troubled relationships and increased interpersonal conflict.

Mental consequences of addiction

In addition to compromised self-control, addiction can cause problems with memory, attention and other decision-making abilities. Many individuals with addiction also experience dysregulated emotions, loss of interest in activities once found pleasurable, increased irritability and hopelessness and other co-occurring mental health disorders, such as depression.

Physical consequences of addiction

Substance use is not only taxing for the brain, but it is also taxing for the rest of the body. Substance use weakens the immune system, which can make an individual more susceptible to disease. It also interferes with an individual’s appetite and sleeping patterns, which often lead to malnourishment. There are also drug-specific consequences, such as smoking marijuana, which irritates the lungs and can contribute to chronic breathing problems.

Cliffside Malibu is an addiction treatment center that has treatment programs available for every level of care. Once you go through our detox program, we will help you establish your sobriety and recovery through a long-term treatment program. We are dedicated to providing a safe and comfortable atmosphere to foster your healing and recovery amidst our luxury treatment facilities. For more information about our programs, give us a call today at (855) 403-5641.